Prediction of pancreatic fistula after pancreatectomy by virtual touch tissue imaging and quantification (VTIQ) technology |
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| Affiliation: | 1. Department of Ultrasound, Zhongshan Hospital, Fudan University, 200032, Shanghai, China;2. Department of Pancreas Surgery, Zhongshan Hospital, Fudan University, 200032, Shanghai, China;1. Division of Endoscopy, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan;2. Division of Genetic Medicine Promotion, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan;3. Division of Pathology, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan;4. Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Nagaizumi, Suntogun, Shizuoka, 411-8777, Japan;1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan;2. Department of Surgery, Fukuoka Higashi Medical Center, Fukuoka, Japan;3. Department of Surgery, Oita Red Cross Hospital, Oita, Japan;4. Department of Hepatobiliary-pancreatic Surgery, Kyushu Cancer Center, Fukuoka, Japan;5. Department of Surgery, Matsuyama Red Cross Hospital, Ehime, Japan;6. Department of Surgery, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan;7. Department of Surgery, Iizuka Hospital, Fukuoka, Japan;8. Department of Surgery, Kyushu Central Hospital, Fukuoka, Japan;9. Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan;10. Department of Surgery, Oita Prefectural Hospital, Oita, Japan;11. Department of Surgery, Fukuoka City Hospital, Fukuoka, Japan;12. Department of Surgery, Munakata Medical Association Hospital, Fukuoka, Japan;1. Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany;2. Clinic of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany;3. Home Address: Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Sheng, China;4. Department of Nuclear Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;1. Department of Gastroenterology, Digestive Endoscopy Center, Changhai Hospital, The Second Military Medical University, Shanghai, China;2. Shanghai Institute of Pancreatic Diseases, Shanghai, China;3. Ningjin Hospital, Hebei Province, China;1. Oncology Pathology, Faculty of Medicine, Kagawa University, Japan;2. Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University, Japan;3. Department of Radiology, Faculty of Medicine, Kagawa University, Japan;4. Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Japan;5. Department of Hygiene, Faculty of Medicine, Kagawa University, Japan;6. Department of Pathology II, Kochi University, Japan;7. Division of Diagnostic Pathology, Ehime University Hospital, Japan;8. Division of Pathology, Tokushima University Hospital, Japan;9. Department of Pathology, Japanese Red Cross Medical Center, Japan;10. Division of Pathology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Japan;11. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, USA;1. Department of Surgery, Pancreas Institute, Verona University Hospital, Verona, Italy;2. Department of Surgery, AGIA OLGA Hospital, Athens, Greece;3. Mayo Clinic Department of General Surgery, Rochester, NY;4. HPB Department, Southampton General Hospital, Southampton, UK;5. Digestive Surgery Department, Lyon Civil Hospital, Lyon, France;6. Memorial Sloan-Kettering Cancer Center, New York, NY;7. Department of Surgery, Clinical Sciences Lund, Lund University, Lund, Sweden;8. Division of General Surgery, Department of Surgery, Mayo Clinic, Jacksonville, FL;9. Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands;10. Department of Surgery, Trinity College Dublin, Tallaght Hospital, Dublin, Ireland;11. Pancreatic Surgery Unit - Division of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC) - Karolinska Institutet at Center for Digestive Diseases Karolinska University Hospital, Stockholm, Sweden;12. Pancreatic Surgery Unit, San Raffaele Scientific Institute, ‘Vita-Salute’ University, Milan, Italy;13. Department of Surgery, Clinic Hospital of Barcelona, University of Barcelona, Barcelona, Spain;14. Department of Surgery, Massachusetts General Hospital and the Harvard Medical School, Boston, MA;15. First Department of Digestive Surgery, Hippokrateon Hospital, University of Athens, Athens, Greece; Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria;p. Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany;q. Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany;r. Department of General, Visceral and Thoracic-Surgery, University Hospital Hamburg-Eppendorf, Hamburg, Germany;s. Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK;t. The Petz Aladar Hospital, Gyor, Hungary;u. Department of Surgery, University of Colorado School of Medicine, Aurora, CO;v. Department of GI and HPB Surgical Oncology, Tata Memorial Hospital, Mumbai, India;w. Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan;x. Division of Hepatobiliary-Pancreatic Surgery and Transplantation, Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan;y. St. Luke''s Clinic - Center For Pancreatic and Liver Diseases, Boise, ID;z. Department of Surgery, Penn Medicine, The University of Pennsylvania, Philadelphia, PA;11. Department of Surgery, Johns Hopkins Medicine, Baltimore, MD;22. Department of Surgery, Jefferson Pancreas, Biliary and Related Cancer Center, Thomas Jefferson University, Philadelphia, PA |
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| Abstract: | ![]()
ObjectivesThe aim of this study was to quantitatively evaluate the stiffness of pancreatic parenchyma and solid focal pancreatic lesions (FPLs) by virtual touch tissue imaging and quantification (VTIQ) technique and to investigate the potential usefulness of VTIQ method in the prediction of post-operative pancreatic fistula (POPF) after pancreatectomy.MethodsIn this prospective study, patients who scheduled to undergo pancreatectomy were initially enrolled and received VTIQ assessment within one week before surgery. VTIQ elastography (Siemens ACUSON Sequoia, 5C-1 transducer) was used to measure the shear wave velocity (SWV) value of FPLs and the body part pancreatic parenchyma. The palpation stiffness of pancreas was qualitatively evaluated during operation by surgeons. POPF was finally diagnosed and graded through a three-weeks post-operative follow-up according to international study group of pancreatic fistula (ISGPF). SWV values were compared between POPF positive and negative group. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of SWV value in predicting POPF.ResultsFrom December 2020 to June 2021, 44 patients were finally enrolled in this study, among which, 26 patients were identified to develop POPF after pancreatectomy. The SWV value of pancreatic parenchyma in POPF positive group was significantly lower than that in POPF negative group (P = 0.001). However, there was no significant difference in palpation stiffness between the two groups (P = 0.124). Besides, neither the SWV value of FPL nor the SWV ratio between FPL to surrounding pancreatic parenchyma differ significantly between POPF positive and negative group (P > 0.05). Taking SWV value of pancreatic parenchyma >1.10 m/s as a cut-off value for predicting POPF, area under the receiver operating characteristic curve (AUROC) was 0.864 with 72.2% sensitivity, 92.3% specificity, 86.7% positive predictive value (PPV) and 82.8% negative predictive value (NPV), respectively.ConclusionsVTIQ technique might be a potential non-invasive imaging method to predict POPF before pancreatectomy in future clinical practice. |
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| Keywords: | Virtual touch tissue imaging and quantification (VTIQ) Shear wave velocity (SWV) Pancreatectomy Post-operative pancreatic fistula (POPF) Prediction |
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